Māori Health Review Issue 37

This study assessed the effects of different strategies for influencing adolescents’ beverage choices in low-income, predominately Black neighbourhoods in Baltimore, Maryland. The intervention randomly posted 1 of 3 signs at the point of purchase with the following caloric information: (1) absolute caloric count, (2) percentage of total recommended daily intake, and (3) physical activity equivalent. Data were collected from 4 neighbourhood stores for 1600 beverage sales to Black adolescents aged 12–18 years, including 400 during a baseline period and 400 for each of the 3 caloric condition interventions. Offering any caloric information at all reduced the likelihood of sugar-sweetened beverage purchases compared with no intervention (OR, 0.56). When examining the 3 caloric conditions separately, there was a significant effect observed only when caloric information was publicised as a physical activity equivalent (OR, 0.51).

The association between geographic access to alcohol outlets and serious violent crime was examined in New Zealand. Serious violence offences recorded between 2005 and 2007 were aggregated for 286 police station areas. Geographical Information Systems geocoded 9,320 licensed premises and road travel distances to the closest alcohol outlet type/category were calculated for each area. Significant negative associations were observed between distance (access) to licensed outlets and the incidence of serious violent offences with increased levels of serious violent offending recorded in areas with close access to any licensed premises compared to those areas with least access (IRR 1.5; 95% CI, 1.10 to 2.03); with on-licensed premises (IRR 1.6; 95% CI, 1.16 to 2.08); and off-licensed premises (IRR 1.4; 95% CI 1.05 to 1.93).

These researchers systematically reviewed sodium content data in the New Zealand processed food supply in order to identify key opportunities for reformulation of processed foods to decrease population sodium intakes. Key opportunities for reformulation were identified by comparing mean sodium content with 2012 targets from the UK Food Standards Agency (FSA) and mean sodium values from Australia and the UK. Major contributors to New Zealand sodium intakes include bread (26%), processed meats (10%), and sauces (6%), with corresponding mean sodium contents of 447 mg/100 g, 1,169 mg/100 g, and 1,046 mg/100 g, respectively. Food categories with the lowest percentage of products meeting corresponding FSA targets were: sausages/ hot dogs and sliced meat (0%); salami/cured meat (2%); liquid meal-based sauces (4%); and multigrain bread (14%). Mean sodium contents of New Zealand products were higher than for similar products in the UK.

These researchers sought to determine whether excess winter mortality in New Zealand varies with social factors. Records from censuses in 1981, 1986, 1991, 1996 and 2001 were each linked to 3 years of subsequent mortality data to create five cohort studies of the New Zealand adult population (age 30–74 years at census). Complete data on social variables were recorded for 58,683 deaths. In logistic regression analysis adjusting for age, sex, census year, ethnicity and tenure, those in the lowest tertile of income were at increased risk of winter death compared to those in the highest tertile (OR, 1.13). Compared to home owners, people living in rented accommodation were at greater risk of winter death (OR, 1.05). Urban dwellers were also at significantly increased risk (OR, 1.05). The strongest associations were seen for infectious diseases.

This study assessed components and determinants of pre-hospital delay in patients with acute coronary syndromes (ACS) admitted to Middlemore Hospital Coronary Care Unit between January 2009 and July 2010. Pre-hospital delay was defined as the time from onset of worst symptom(s) to defibrillator availability: either ambulance arrival at the scene or time of hospital arrival (non-ambulance patients). For 805 patients the median delay from symptom onset to defibrillator availability was 174 minutes; the delay to defibrillator availability was >3 hours for 50% of the cohort. The median delay was an hour longer for patients from areas of greatest deprivation compared with those from less deprived areas (208 vs 149 min; p=0.015) and 7 hours longer for non-ambulance vs ambulance patients (553 vs 130 min; p<0.001). Māori, Pacific, Indian and those from areas of higher deprivation were less likely to travel to hospital by ambulance. Of ST-elevation myocardial infarction patients eligible for reperfusion, over two-thirds of the total delay between symptom onset and reperfusion occurred pre-hospital.

This paper describes the size and shape of Māori tamariki (child) and taiohi (adolescent) traumatic brain injury (TBI) and reviews the wider international literature related to cultural factors and TBI. Scant research focuses on children and young people at highest risk of TBI. There is evidence of Māori tamariki and taiohi being significantly over-represented in TBI populations, with poorer outcomes including higher mortality rates. According to international research, ‘minority’ culture is a risk factor for certain causes of injury and a differential rehabilitation service response.

Data from the cross-sectional Youth 07: National Survey of the Health and Wellbeing of New Zealand Secondary School Students were explored to describe secondary school students’ use of dental services and determine the nature and extent of any inequities by deprivation status and ethnicity. The researchers also examined students’ toothbrushing practices and self-reported dental pain experience, past restorative treatment and tooth loss. The survey involved a representative sample of 9,098 secondary school students aged 13–17 years from 96 secondary schools across New Zealand. Seventy-two per cent of participants reported a dental visit in the previous 12 months; those who were more likely to have done so included females, those who brushed at least twice daily, and those who had been kept awake at night by dental pain. Those who were less likely included those identifying with Māori, Pacific or Asian ethnicity (and those in the ‘Other’ ethnic category) relative to European students, and those residing in medium- or high-deprivation areas relative to those in low-deprivation areas. One in seven participants reported having lost a tooth due to oral disease. Having had a tooth filled was reported by almost three-quarters of the sample, and having been kept awake by dental pain at night was reported by just over one in five. Almost two-thirds reported brushing their teeth twice or more in the previous 24 hours, and a small minority had not brushed at all.

Data from the cross-sectional Youth 07: National Survey of the Health and Wellbeing of New Zealand Secondary School Students were explored to describe secondary school students’ use of dental services and determine the nature and extent of any inequities by deprivation status and ethnicity. The researchers also examined students’ toothbrushing practices and self-reported dental pain experience, past restorative treatment and tooth loss. The survey involved a representative sample of 9,098 secondary school students aged 13–17 years from 96 secondary schools across New Zealand. Seventy-two per cent of participants reported a dental visit in the previous 12 months; those who were more likely to have done so included females, those who brushed at least twice daily, and those who had been kept awake at night by dental pain. Those who were less likely included those identifying with Māori, Pacific or Asian ethnicity (and those in the ‘Other’ ethnic category) relative to European students, and those residing in medium- or high-deprivation areas relative to those in low-deprivation areas. One in seven participants reported having lost a tooth due to oral disease. Having had a tooth filled was reported by almost three-quarters of the sample, and having been kept awake by dental pain at night was reported by just over one in five. Almost two-thirds reported brushing their teeth twice or more in the previous 24 hours, and a small minority had not brushed at all.

This study investigated the prevalence of self-reported experience of racial discrimination in New Zealand by ethnicity, changes over time and associations with multiple health measures, using data from the 2002/03 (n=12,500) and 2006/07 (n=12,488) New Zealand Health Surveys, nationally representative population-based surveys of adults (≥15 years). Reported experience of racial discrimination was measured in both surveys and covered 5 items: experience of an ethnically motivated physical or verbal attack; and unfair treatment because of ethnicity by a health professional, in work, or when gaining housing. Reported experience of racial discrimination increased between 2002/03 (28.1% ever) and 2006/07 (35.0% ever) among Asian peoples but remained largely unchanged for other ethnic groupings (Māori 29.5%, Pacific 23.0%, European 13.5%). Experience of racial discrimination was associated with all negative health measures except excess body fat. Where there were significant associations, a dose-response relationship was also evident.

This study examined the role of noradrenergic mechanisms in the generation of implicit racial attitudes and involved 36 healthy volunteers of White ethnic origin, who were randomised to receive a single oral 40 mg dose of the β-adrenoceptor antagonist, propranolol (n=18) or a placebo (n=18). Participants completed an explicit measure of prejudice and the racial implicit association test, 1–2 h after propranolol administration. Relative to placebo, propranolol significantly lowered heart rate and abolished implicit racial bias, without affecting the measure of explicit racial prejudice. Propranolol did not affect subjective mood.

These researchers developed and applied a systematic method in order to monitor all hospital admissions for infectious and non-infectious diseases in New Zealand from 1989 to 2008. They investigated trends in incidence and distribution by ethnic group and socioeconomic status. Infectious diseases were the largest contributor to hospital admissions of any cause, increasing from 20.5% of acute admissions in 1989-93 to 26.6% in 2004-08. Ethnic and social inequalities were noted for infectious disease risk. In 2004-08, the age-standardised rate ratio was 2.15 for Māori (Indigenous New Zealanders) and 2.35 for Pacific peoples compared with the European and Other groups. The ratio was 2.81 for the most socioeconomically deprived quintile compared with the least deprived quintile. These inequalities have increased substantially in the past 20 years, particularly for Māori and Pacific peoples in the most deprived quintile.